How to apply for BCN 65 nongroup

Follow these instructions to apply for BCN 65:

  1. Complete and sign the BCN 65 Enrollment Form. You can call Customer Service at 1-800-662-6667 to get an enrollment form.
  2. Determine your monthly premium. Issue a check or money order payable to Blue Care Network of Michigan for your first month's premium.
  3. Mail the completed enrollment application and your check or money order to:

    Membership — Mail Code C411
    Blue Care Network
    20500 Civic Center Drive
    Southfield, MI 48086

    Enrollment applications are accepted year-round, and approval is contingent upon your passing our insurance guidelines. If you are not accepted, your premium will be returned.

page modified 03/02/2010